The clinical symptoms of functional constipation in the elderly are more unique which represents as over concern about their bowel movement,excessive straining and worse feelings to the constipation.The intestinal physiological function declining with age,reductions of enteric neurons and interstitial cells of Cajal,neuronal degeneration and injured contractibility of intestinal smooth cells are enrolled in the pathogenesis of functional constipation.More attention should be paid to drug interactions and adverse effects in clinical practice due to more underlying disease and concomitant medication in the elderly.

Carcino-embryonic antigen related cellular adhesion molecule 1(CEACAM1),used to be called CD66a, biliar glyeoprotein(BGP) or C-CAM,is a glucoprotein expressed on the surface of cells, a member of the carcino-embryonic antigen family(CEA) and an adhesion molecule of immunoglobulin superfamily. It is widely expressed on the epithelial cells and vascular endothelial cells.CEACAM1 inhibits tumor growth and epithelial cell proliferation, induces apoptosis of epithelial cells, inhibits activation and proliferation of T lymphocytes, stimulates proliferation of B lymphocytes, inhibits the cytotoxic effects of T cells and NK cells, delays apoptosis of granulocytes and monocytes, inhibits the activity of tumor-infiltrating lymphocytes, stimulates invasion of tumor cells and motility of endothelial cells, promotes blood vessel angiogenesis, and modulates vascular remodeling, so it has many important biological functions.

ObjectiveTo explore the relationship between coping modes and depression in stroke patients accepting rehabilitation initially. Methods30 stroke patients were assessed with Medical Coping Modes Questionnaire (MCMQ) and Self-rating Depression Scale (SDS). ResultsThe score of resignation in MCMQ was significantly higher in depression group than in non-depression group （P<0.01). There was correlation between scores of resignation and SDS (r=0.416, P=0.003). ConclusionDepression may relate with resignation in stroke patients admitted in the hospital for rehabilitation initially.

Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.

Objective To investigate the correlation between the mutation of pncA gene and the susceptibility to pyrazinamide ( PZA) in Mycobacterium tuberculosis complex ( MTBC) strains and to analyze the mutation of panD and rpsA genes in wild type isolates without pncA gene mutation.Methods The sus-ceptibilities of 108 MTBC strains to first-line drugs including PZA were detected by using the MGIT 960 TB system.PCR was performed to amplify the 16S rDNA and pncA, panD and rpsA genes.The PCR products were analyzed by DNA sequencing analysis .Results Among the 78 multidrug-resistant MTBC strains , 47 isolates (60%) were resistant to PZA.Four out of 30 (13%) strains that were sensitive to ethambutol , iso-niazid, rifampicin and streptomycin (EIRS) were resistant to PZA.The drug-resistant MTBC strains showed higher resistance rate to PZA than that of the EIRS sensitive strains .There were 49 ( 96%) PZA-resistant isolates and 4 (7%) PZA-sensitive isolates occurred pncA gene mutation.Most of the pncA gene mutations in the genomes of PZA-resistant strains were base substitution mutation , especially the His57Asp substitu-tion.The pncA gene mutations centralized in the regions of 160-169, 203-289, 309-396 and 413-467.Seven novel mutation sites of pncA gene were observed including T175C, C188A, G insertion at 68, AGC insertion at 235, C insertion at 339, CC insertion at 392 and GT deletion at 395.The mutation sites founded in the genomes of PZA-sensitive strains were different from those of the PZA-resistant strains .No mutation of the pncA gene and the upstream regulatory sequence was found in two PZA-resistant strains , NJ44 and NJ108 . The sequence analysis of panD and rpsA gene showed that the NJ 108 strain had panD gene mutation at G419A, but no mutation was detected in the NJ 44 strain.Conclusion The multidrug-resistant MTBC strains showed higher resistance rate to PZA .The pncA gene mutation was common in PZA-resistant MTB strains and the panD gene mutation was also worthy of attention .

Objective To explore the source of endothelial cells in tumor vessels by A 549 tumor model with GFP nude mouse.Methods To establish the A 549 lung cancer models with GFP nude mice, expression of CD 31 was determined by immunofluorescence to label tumor vessels; to observe and take a picture of the tumor frozen section by confocal microscopy and invert microscope;expression of GFP in tumor vessels was determined by immunohistochemistry. Result The results of immunofluorescence showed:Tumor interstitial vascular endothelial cells or endothelial cells clusters and micro-vascular lumen size and shape are clearly visible by immunofluorescence, and part of vessels with no obvious lumen or irregular lumen.We can see green fluorescent in tumor cells of tumor tissue and endothelial cells which form of tumor vessels.The results of immunohistochemistry showed: expression of GFP was determined in cytoplasm of tumor stromal cells and endothelial cells in tumor vessels.Conclusion The endothelial cells which formed tumor neovessels that derived from GFP nude mice partly and the other part derived from tumor cells.

Objective To investigate the role of PPAR-γ in the gene expression of T-bet/GATA-3 in Jurkat T cells,and to explore the mechanisms underling this sensitizing effect of the change of TH cell subpopulation group.Methods Jurkat T cells were stimulated with PPAR-γ agonist pioglitazone.TH cell related cytokine IFN-γ and IL-10 was detected by ELISA,and the expression of transcription factors(T-bet and GATA-3)mRNA was detected by RT-PCR.To prove the PPAR-γ-dependent effect.the PPAR-γ-specific antagonist GW9662 was used.Results Stimulated with agonist PPAR-γpioglitazone.the concentration of IFN-γ and IL-10 and the expression of transcription factor T-bet and GATA-3 mRNA were both significantlY decreased in Jurkat T cells obviously,and these actions were dependent on the time and the concentrations of pioglitazone.Added with antagonist GW9662 at the same time,such inhibitory actions of IFN-γ and T-bet expression were recovered.but not IL-10 and GATA-3.Conclusion Pioglitazone can inhibite T cells proliferation and their secretion of cytokines.Pioglitazone can inhibit TH1 cells from secreting cytokines,and it is a PPAR-γ-dependent effect related to T-bet.The inhibition on TH2 is not a PPAR-γ-dependent effect and it is GATA-3 related.

Objective To investigate the trend of antimicrobial resistance and the prevalence of resistant genes in Pseudomonas aeruginosa strains isolated from Hangzhou First People's Hospital.Methods Antimicrobial susceptibilities of 1489 Pseudomonas aeruginosa strains isolated from 2003 to 2007 were statistically analyzed using WHONET.MICs of 11 antimicrobisis to 36 multi-drug-resistant Pseudomonas aerugionosa strains were determined by agar dilution method.Genes of β-lactamases(BLA)and aminoglycoside-modifying enzymes(AMEs)were detected by PCR and the PCR products were sequenced.Results The resistant rates to aztreonam,imipenem,ceftazidime,cefepime,piperacillin,piperacillin/tazobactam.cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and amikacin were increased from 13.4%,10.6%,8.7%,7.9%,12.7%,12.7%,6.7%, 15.8%,20.5%,24.7% and 10.9%in 2003 to 35.3%,40.9%,18.4%, 32.4%,32.9%,32.0%,21.9%,37.8%,38.6%, 39.4% and 34.8% in 2007.respectively.Hish MICs of 11 antimicrobiMs for multi-drug resistant Pseudomonas aerouginosa were determined with MIC90≥128 μg/mL.In 36 multi-drug resistant Pseudomonas aeruginosa strains,21(58.3%)strains carried β-lactamase genes and 32 strains(88.9%)carried aminoglycosidemodifying enzyme genes,while the deletion rate of oprD2 was 80.6%(29/36).Conclusions The resistant rates to common antibiotics of Pseudomonas aeruginosa have increased.resulting in multi-drug resistance.Genes of β-lactamases and aminoglycoside-medifying enzymes are prevalent in multi-drug resistant Pseudomonas aeruginosa strains,with the common deletion of oprD2.

Objective To investigate the prevalence of BRAF T1799A mutation and RET/PTC rearrangement in Qingdao and detect the expression of platelet-derived growth factor B (PDGF-B) in order to investigate the correlation between gene mutation and PDGF-B.Methods Fresh tissue from 48 papillary thyroid carcinomas (PTC) patients was examined for BRAF mutation RET rearrangements (RET/PTC1 and RET/PTC3) by PCR,followed by direct-sequence analysis.The expression of PDGF was analyzed by immunohistochemistry.Results Among the 48 patients,14 (29.2％) were micro PTC; 18 (37.5％) had BRAF T1799A mutations and 23(47.9％) had RET/PTC rearrangement.There were 17 (35.4％) cases of RET/PTC1 and 6 (12.5％) of RET/PTC3,with no multiple rearrangements.Both BRAF T1799A mutation and RET/PTC rearrangement were present in 6 (12.5％) cases of non-micro PTC.The level of PDGF-B expression in BRAF T1799A positive was higher than that in the negative,and the level of PDGF-B expression in RET/PTC3 was higher than that in RET/PTC1 (P ＜ 0.05).The more advanced neoplasm stage was,the stranger PDGF-B expression was.Conclusions The incidence of BRAF T1799A mutation and RET/PTC rearrangement is higher in Qingdao.BRAF T1799A mutation and RET/PTC3 rearrangement in patients suggests a poorer prognosis than the negative one.The BRAF T1799A mutation and RET/PTC3 rearrangement may strengthen the expression of PDGF-B.Both variations suggest a poor prognosis.

Objective To evaluate the implementation of the national essential medicine system in Shaanxi Province.Methods Using a standardized methodology (2008 Edition) developed by the World Health Organization(WHO) and Health Action International(HAD,data on the prices and availability of 38 essential medicines were collected from 120 primary,secondary and tertiary public hospitals in ten cities of Shaanxi Province from March to May 2012.Results The availability of essential medicines is generally low at public hospitals in Shaanxi province,as the average availability of originator brands is but 5.9％,and that of generics of the lowest prices is but 23.9％,while this availability at tertiary hospitals is higher than hospitals of lower levels.The procurement prices of originator drugs within essential medicines are distinctly higher than the international reference prices for the originator brands,and slightly higher for the lowest priced generics.The procurement prices at primary care hospitals are slightly lower than that of other hospitals.Retail prices of essential medicine are not significantly different among regions of different income levels.Affordability of originator brands is poor,while that of their generic equivalents is good.Conclusion The government is recommended to adjust the national essential medicine list,expand the variety of essential medicine moderately,improve the medicine pricing mechanism,and deepen public hospitals reform.